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A parent's guide to childhood vaccinations

Children get as many as 25 shots and boosters in the first 15 months of life alone. When you combine the sheer number of vaccines with an alphabet-soup-like jumble of acronyms it’s hard to keep track of what a youngster is getting—and why.

Here’s a rundown of 12 vaccines that help protect against potentially life-threatening germs. Most are required for school attendance, while some are not. (Legal requirements can vary from state to state.)

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Hepatitis B

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Your newborn should get this shot even before leaving the hospital, and receive another dose at 1 to 2 months and a third at 6 to 18 months. The vaccine protects against an incurable, liver-infecting virus, hepatitis B, which can be passed to a baby during childbirth if the mother is infected.

This virus spreads through contact with blood or other body fluids (sharing toothbrushes and utensils can put you at risk).

Soreness at the site of the shot, or a slight fever, is the most common side effect, according to Gabrielle Gold-von Simson, MD, assistant professor of pediatrics at NYU Langone Medical Center in New York.

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DTaP

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The DTaP vaccine protects against diphtheria (a germ that can form a gray or black film in the throat), tetanus (an infection that can cause muscle spasms so strong they can break bones), and pertussis (a highly contagious disease that causes a severe, uncontrollable cough, known as whooping cough).

Five vaccine doses are given to children at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. (And boosters at age 11 or 12 and then every 10 years.)

DTaP may be combined with other vaccinations to reduce the number of shots needed. “Now, it’s DTaP with hepatitis B and the polio vaccine. So, it’s five in one,” Dr. Gold-von Simson says.

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MMR

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This combo shot protects against three viruses: measles (which causes high fever and a body-wide rash); mumps (which causes face pain, swelling of the salivary glands, and sometimes scrotal swelling in boys); and rubella or German measles (which can cause birth defects if the infection occurs during pregnancy).

The first shot is given at 12 to 15 months of age and once again between the ages of 4 and 6.

MMR is sometimes combined with the chickenpox vaccine into one shot (brand name ProQuad). “All these different preparations are designed to reduce the amount of shots the pediatrician has to give,” says Dr. Gold-von Simson.

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Chickenpox

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Chickenpox, a highly contagious rash that many people remember from childhood, is caused by the varicella virus. A varicella vaccine was first licensed in 1995 and now spares future generations this itchy misery.

Chickenpox infections can be especially dangerous in adults who don’t have immunity from the vaccine or haven't had it in childhood, and can also lead to shingles, an extremely painful blistering rash.

The shot is given to children at 12 to 15 months and again between 4 and 6 years. The vaccine can cause soreness at the site of the shot, fever, and, in some cases, a mild rash.

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Haemophilus influenza type B (Hib)

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“Haemophilus influenza type b is the bacterium that causes meningitis,” says Dr. Gold-von Simson. Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, is particularly dangerous for kids under the age of 5.

Hib vaccines are generally given at 2, 4, 6, and 12 to 15 months of age. Depending on the vaccine used, the 6-month shot may not be needed.

Fever, swelling, and redness at the site of the shot are potential side effects.

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Pneumococcal conjugate (PCV)

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This vaccine, known as PCV13 (brand name Prevnar 13), protects against 13 types of Streptococcus pneumoniae, which are bacteria that can cause all sorts of mayhem, including meningitis, pneumonia, ear infections, blood infections, and even death.

A total of four shots are given to kids (at 2, 4, 6, and 12 to 15 months of age) to protect them against the germs, known collectively as pneumococcal bacteria.

The most common side effects of the vaccine include drowsiness, swelling at the site of the shot, mild fever, and irritability.

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Influenza (flu)

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Flu vaccinations are given each year starting in the fall. The Centers for Disease Control and Prevention recommends them for kids ages 6 months or older, although they aren’t required for school attendance. (Connecticut and New Jersey require the vaccine for attending child-care centers and preschool.)

Common side effects from the vaccine include soreness, redness, or swelling at the site of the shot. Fever and aches may occur too.

“If you have an egg allergy, you shouldn’t have the influenza vaccine,” says Dr. Gold-von Simson.

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Rotavirus (RV)

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The rotavirus vaccine (RV) (brand names RotaTeq, Rotarix) is given to children at 2 and 4 months of age. (RotaTeq is also given at 6 months.) The vaccine protects against a virus that is the most common cause of severe diarrhea and vomiting in young kids worldwide. About 55,000 children in the U.S. were hospitalized each year due to rotavirus before the vaccine was licensed in 2006.

It is not required for school attendance.

The vaccine is in liquid form and given by mouth to babies. It may make them a bit more irritable and can also cause mild diarrhea or vomiting.

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Hepatitis A

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Kids can catch hepatitis A from sharing food or drinks or by putting contaminated food or objects in their mouths. It’s a viral infection that affects the liver, and can cause a number of symptoms, including fever, tiredness, jaundice, and loss of appetite.

Children ages 12 through 23 months generally get two doses of the Hep A vaccine, with a minimum interval of six months between shots. Some states require the vaccine for school attendance.

Soreness where the shot was given, headache, and loss of appetite are the most common side effects of the vaccine.

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Meningococcal conjugate (MCV4)

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This vaccine, known as MCV4 (brand names Menactra and Menveo), protects against meningococcal bacteria, which can infect the membranes surrounding the brain and spinal cord. MCV4 is recommended for kids at 11 or 12 years of age, and anyone between ages 2 and 55 who is at increased risk of infection (people with certain health conditions, military recruits).

Teens starting college should be vaccinated with MCV4 before going to school if they didn’t previously get the shot. (Freshman living in dorms are at increased risk of infection.)

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Human papillomavirus (HPV)

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Human papillomavirus (HPV) vaccine (brand names Gardasil, Cervarix) is given in three doses over a 6-month period, and is approved for girls between ages 9 and 26.

While there are over a hundred types of HPV, this vaccine protects against two sexually transmitted types that are the most common causes of cervical cancer. Gardasil also protects against two types that cause genital warts and is approved for boys between 9 and 26 as well.

The vaccine works only if given before an infection, so doctors recommend it for kids well before they could become sexually active. Although most states don’t require HPV vaccination, many are considering mandating it for preteen girls.